KAKETHIA S. MACK

ELLENWOOD, GA
NPI1346748837
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  RN154797)
Enumeration Date2018-01-30
Last Update Date2018-07-02
Business Address
Ms. KAKETHIA S. MACK Nurse Practitioner
4124 BOSENBERRY WAY
ELLENWOOD, GA 30294
Phone number: 678-463-6568
Mailing Address
Ms. KAKETHIA S. MACK Nurse Practitioner
4124 BOSENBERRY WAY
ELLENWOOD, GA 30294-4265
Phone number: 678-463-6568
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